At Dhorlewadi primary health centre (PHC),60 km from Baramati taluka in Pune district,auxillary nursing midwife (ANM) Jayashree Dalvi is busy feeding in data about the number of pregnant women who have registered last month. A health check-up camp will be held on Wednesday where vehicles will be sent to the homes of these pregnant women in the village to fetch them for the camp. Routine blood and urine tests to check their haemoglobin counts,blood pressure levels and other health checks will be done by inviting a gynaecologist from a private hospital. At the end of the camp,a nutritious meal will be served to all the women. Dalvi,who has been working at the PHC for the last 25 years,says the Mother-Child Tracking Software (MCTS) project,initiated by the Central government to reduce maternal and infant mortality,has made it easier to register and track pregnant women and their children. The MCTS system,developed and installed a year ago,aims to track every pregnant woman and child in the 13 talukas of the district. I have been given a target of covering a population of 6,000. We conduct our survey by visiting every house. On average every month,some 9-10 women are registered as pregnant, says Dalvi. Vijaya Nimbalkar,32,an ANM at Nere village in Bhor taluka,rides her two-wheeler in the remote areas of Bhor taluka to visit homes and identify women who are pregnant. I have been given a target of covering a population of 11,500 in 12 villages. A colleague and I survey the homes,collect information and feed data in the 57 columns as part of the MCTS project. Information regarding the last menstrual period,date of delivery,vaccination,blood pressure check-up and so on are filled in by the ANMs and multipurpose workers (MPWs) at 96 PHCs in the district. Despite problems of loadshedding and the lack of enough medical facilities in some remote areas of Bhor taluka,pregnant women are now guaranteed assistance even during the wee hours of the morning,says Nimbalkar. Both Dalvi and Nimbalkar are among the ANMs and MPWs who have been trained to identify pregnant women,track them,give them an Antenatal Care (ANC) card,register their identification and ensure that they are taken to hospitals for deliveries. The health workers fill in all the requisite columns about the condition of the pregnant women and send a mail to the health officers of the Pune Zilla Parishad,who then activate their machinery to ensure that the women due for delivery that month are provided with transport and other health benefits. The district health officials have compiled data on pregnant women who are due for delivery over the next three months and have taken steps to ensure that their requirements are met. For a year now,the mother-child tracking project has had a successful run in Pune district. The rate of deliveries done at home has reduced by over four per cent. In 2010-11,7.8 per cent of the 71,460 deliveries were done at home while the figure fell to 4.2 per cent from among the 73,249 deliveries performed in the district in 2011-12. The tracking software has now been installed in all the 96 PHCs and such has been the success of the programme in the rural areas of Pune district that even sterilisation drives have overshot the target. Dr V S Kamalapurkar,district reproductive and child health officer,says that from 28 maternal deaths and 61,743 live births in 2010-11,maternal deaths have been brought down to 20 and the number of live births have gone up to 62,771. ANMs have to ensure that the pregnant woman is looked after during the pregnancy and after the delivery and that everythingher vaccination shots,blood and urine tests and gynaecological check upsis up-to-date. The infant is also monitored. Dr Sudhakar Kokane,a district health officer,said a toll-free number,1800233460,had been announced,where requests could be made for free-of-cost vehicular transport. Anil Kawde,CEO of Pune Zilla Parishad,says several initiatives have been launched by the centre such as the Janani Shishu Suraksha Karyakram to improve services for pregnant women and newborns. The centre has also provided the software to all districts in the states as part of the objective to bring down maternal and infant mortality rates. In Pune district,the infant mortality rate has been brought down from 19 for every 1,000 live births in 2010-11 to 15 per 1,000 live births. Kawde pointed out that new schemes to reach women in the remotest areas of the district would soon be launched.
